TVT 2017: “I predict a very exciting and bright future” for transcatheter valve therapies

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Martin Leon

This year marks the 10th anniversary of the Transcatheter Valve Therapies (TVT) meeting (14–17 June, Chicago, USA). Course director Martin B Leon (Interventional Vascular Therapy, Columbia University Medical Center, New York Presbyterian Hospital, New York, USA) talks to Cardiovascular News about why the meeting was set up, its core aims, and what he thinks the key developments in transcatheter valve therapies will be in the next 10 years.

Why did you decide to set-up TVT?

In 2007, due to the development of transcatheter aortic valve implantation (TAVI) as a potential new therapy and the initiation of the US PARTNER trial, we felt we were at the beginning of a therapy that had the potential to radically change the way we manage patients with valvular heart disease.

Therefore, we thought a scientific meeting would allow us to discuss some of the work that was being done and to bring together thought leaders to stimulate the field.

What is the ethos of TVT?

TVT has many of the same goals as the “parent” Transcatheter Cardiovascular Therapeutics (TCT) meeting. The primary goal of TCT has been to provide education for practising physicians to learn about new technologies and interventional techniques to be applied in their patients. One of the ways we provide this education is by using live case transmissions to convey the operator decision-making processes. Furthermore, we have always believed that these meetings should be highly academic (promoting evidence-based medicine), should be multidisciplinary, and should reach a global audience.

How has the meeting grown over the last 10 years?

TVT is now become a major meeting—it is the largest meeting dedicated to valvular heart disease in the USA. This year, we will have 11 live cases from four different venues, 50 posters, 60 challenging cases, eight workshops, nearly 1,000 lectures, and almost an entire day dedicated to imaging modalities to diagnose and guide therapy of valve patients. I believe TVT, alongside PCR London Valves, has become one of the most meaningful meetings in this area.

What do you think the highlights will be of this year’s meeting?

On the first evening, there is going to be a live case from Vancouver featuring transcatheter mitral valve replacement. On that same evening, there will also be a “live in a box” of a new device for transcatheter mitral valve annuloplasty repair.

On the morning of the first day, there will be an inaugural session with a series of presentations that I believe will help to put the field into perspective. TVT is meant to educate and help train physicians caring for patients and to stimulate innovation in the field of transcatheter therapies for valvular heart disease. I am confident that this year’s meeting content will fulfil these important objectives.

How has the field of transcatheter valve therapy changed over the last 10 years?

The field began decades ago with balloon mitral valvuloplasty for mitral stenosis. There is no question that—over the past decade—TAVI has completely overwhelmed this field beyond everyone’s expectations. TAVI is now fuelling the entire valve field, allowing us to dream creatively about how we can apply transcatheter approaches to treat more complex problems in patients with mitral and tricuspid regurgitation. At the moment, we are now seeing a plateau in TAVI with a concomitant growth in transcatheter mitral and tricuspid therapies. This is reflected in TVT this year. In previous years, we have struggled to get enough content to fill the mitral and tricuspid sections, but this year, we have an overflowing amount of new content in these areas. Also, the majority of live cases this year are related to mitral and not the aortic valve. We are seeing this very interesting transition from a rapidly maturing aortic space to a rapidly evolving and developing mitral and tricuspid space.

What do you think will happen in the next 10 years?

I think we will continue to see further maturation of transcatheter aortic valve therapies. We have just published data for intermediate-risk patients and, at the moment, there are two large ongoing US studies in low-risk patients. Also, we are about to begin new studies in asymptomatic aortic stenosis patients and in moderate aortic stenosis with reduced ejection fraction.

At the same time, I think we are going to unravel the Gordian knot of new transcatheter therapies  to manage the conundrum of mitral and tricuspid regurgitation, which are multifaceted and multifactorial problems.  So, I predict a very exciting and bright future for the treatment of valvular heart disease using these new and innovative transcatheter therapies and we hope that TVT can convey this message to our physician attendees.

 

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